Ataxia

An individual with ataxia has rapid muscle tone fluctuation which can vary from low to normal tone. Because ataxia is a movement disorder, it can have a disorganizing effect on day-to-day functioning. The fluctuation of muscle tone is most observable in the arms and hands, but it also occurs in the trunk and oculomotor (visual-motor) system. With ataxia, stretch reflexes and balance reactions are frequently exaggerated leading to problems with balance and coordination.

Here are some suggestions for working with students who have ataxia:

-Work close to the body or trunk with consistent placement of the hands.

-Provide firm pressure- pull the rib cage down with heavy, consistent control.

-Work to develop control of a few midrange positions and postures.

-Include exercises to strengthen the triceps.

-Always work rhythmically and predictably.

-Provide a source of support for stability, such a something to hold onto while working.

-If the child is mobile, provide support and guidance while walking and have the child visually search for objects so he will not stabilize using the visual (occulomotor) system for compensation, which can be a safety hazard.

-Always tell the child when you are changing activities or placement of materials.

-Place objects in the same spot repeatedly for consistency.

-Work on dycem or other non-skid material for stability.

-Provide heavy toys to play with or use weighted wrist cuffs (consult a therapist to see which weight is most appropriate for each individual child)

-Use firm theraputty for hand exercise.

-Weighted utensils, and weighted pens and weighted pencils are good.

-Be aware of potential fatigue issues and provide frequent breaks if necessary.

-Always consult a physical or occupational therapist if you have specific questions when working with a student with ataxia.

For more information on ataxia, consult the following website: http://www.ataxia.org/learn/ataxia-diagnosis.aspx 

Photo Credit: Ambro @ freedigitalphotos.net

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Tummy Time Tips

     I guess it's because I'm a therapist, but moms frequently ask me, “Is tummy time really that important?”  This is an important and valid question, and every parent needs to know the answer. Tummy time plays a critical role in infant development, as it provides a base for motor skills such as head control, rolling over, and pulling up.

     Tummy time is especially important now that that the American Academy of Pediatrics (AAP) recommends that all babies sleep on their backs. Prior to 1992, most babies in the United States slept on their stomachs, but years of scientific research revealed that infants were approximately 12 times more likely to be found on their stomachs than on their backs when they had died of Sudden Infant Death Syndrome (SIDS). So in 1992 the AAP formally recommended that all infants be placed to sleep on their backs or sides to reduce the risk of SIDS. Later, the side position was eliminated from the recommendation because infants could roll from their sides to their stomachs during sleep. Since this extremely successful marketing campaign, 50% fewer infants have died from SIDS. Putting babies to sleep on their backs turned out to be a simple and effective way to save the lives of infants.

     Eventually, pediatricians and therapists noticed a sudden rise in infants diagnosed with flat spots on the head, and they also noticed an increase in the number of infants with mild delays in gross motor skills, such as rolling over and pulling up. Evidently, many parents were not positioning their infants on the tummy for play out of a fear of SIDS, and this limited tummy time was having some negative consequences. In 1996, the AAP formally recommended that parents provide babies with supervised playtime on the stomach to promote growth and development and prevent flat spots from forming on the head.

     My research has revealed that many infants resist being placed on the belly. This is probably because they aren’t familiar with tummy time and haven’t gained the head control and upper body strength that is necessary to maintain the position comfortably. But rest assured, with time and a few basic and very beneficial techniques, any infant can learn to tolerate tummy time. There is a solution to the problem, and there are ways to introduce tummy time and increase tolerance without making a parents’ and baby’s life miserable. In fact, it can be the total opposite of miserable. Tummy time provides an opportunity to spend one on one time with baby and create a special bond that can last a lifetime!

     In the beginning you should set up a regular schedule for tummy time. You can plan to carry it out after naps or after diaper changes, just be sure to have a plan in place. A general guideline should be that half of the time that baby spends for play should be on the tummy, and remember, it is important to vary your baby’s position every 15 to 20 minutes during playtime. It is important to be aware that tummy time is any combination of positions in which your infant is NOT on the back and encourages baby to use the back, shoulder and neck muscles. This includes time spent in your arms and on your lap. Most importantly, don’t look upon tummy time as a chore, keep in mind that this special time is an important part of baby’s daily routine, which provides an opportunity to bond and develop the close relationship with your infant that you’ve always dreamed of.

Also, for more information about tummy time as well as some wonderful brochures and handouts, visit http://www.pathwaysawareness.org/. 

Tummy Time Therapy Blogger Blog Hop

Below you will find all the posts in the Tummy Time therapy blogger blog hop. So many great ideas and thoughts on tummy time from Occupational Therapist and Physical Therapists.

The Importance of Tummy Time for Babies - Golden Reflections Blog

Tummy Time & Baby's First Year - The Recycling OT

How to Use a Therapy Ball to Make Tummy Time Easier and More Fun for Baby - Mama OT

5 Awesome Toys for Tummy Time! - The Inspired Treehouse

Terrific Tummy Time Positions - Your Kids OT

Tips For Tummy Time From A Physical Therapist - Pink Oatmeal

Tummy Time : The Basics - Therapy Fun Zone

Tummy Time: Developmental Consequences & Future Implications - Tools to Grow, Inc.

Tummy Time Tips - Pedatric OT Tips

Tummy Time Just Isn't For Babies - Your Therapy Source

Tummy Time - More Than Just A Buzz Word - Starfish Therapies

Tummy Time Never Gets Old - Playapy Platform

Daily Living Skills Worksheets

A fellow blogger and occupational therapist, Linda Harrison,  recently sent me a copy of her wonderful Daily Living Skills Worksheets. This book of reproducible worksheets is great for teaching independent living skills and is ideal for use with individuals with a variety of diagnoses. I work in the school setting, and I am excited to have so many different worksheets addressing skills such as goal-setting, memory/safety, and time/money management (and much more!) to use with my middle and high school students with special needs. I am highly impressed with the "functional" and "practical" nature of the worksheets...from making out a grocery list to using the bus! Go to Linda's website @ www.lindasdailylivingskills.com to check out this amazing resource for yourself!